硝酸甘油对深低温停循环心肺转流降温和复温的影响

摘要

目的 探讨硝酸甘油对深低温停循环心肺转流(deep hypothermic circulatory arrest cardiopulmonary bypass,DHCAC)降温和复温的影响.方法 选择行DHCAC下全主动脉弓置换手术患者46例,男38例,女8例,年龄26~74岁,ASA Ⅳ或Ⅴ级,随机分为研究组(n=24)和对照组(n=22).两组均采用相同的变温方法.研究组在降温和复温期间持续静脉泵入硝酸甘油,对照组则泵入相同体积的生理盐水.记录两组患者直肠温复温时间以及鼻咽温降温、复温时间.结果 研究组直肠温复温时间明显短于对照组[(104±30)min vs (127±31) min,P<0.05].研究组和对照组鼻咽温降温时间[(53±10) min vs (57±13) min]、复温时间[(73±20) min vs (84±30) min]差异均无统计学意义.结论 硝酸甘油能够缩短深低温停循环心肺转流直肠温的复温时间.%Objective To determine the effects of nitroglycerine on cooling and rewarming during cardiopulmonary bypass with deep hypothermic circulatory arrest (DHCAC).Methods Forty-six patients undergoing total aortic arch replacement with DHCAC, 38 males and 8 females, aged 26-74 years, falling into ASA physical status Ⅳ or Ⅴ, were randomly assigned to study group (n=24) and control group (n=22).The same cooling and rewarming methods were implemented in both groups.During cooling and rewarming, the study group received nitroglycerine infusion and the control group normal saline of same volume.The rectum rewarming time, the nasopharyngeal cooling and rewarming time were measured and compared.Results The time of rewarming rectum was significantly shorter in the study group compared to the control group [(104±30) min vs (127±31) min, P<0.05].There was no difference in cooling time , time of rewarming nasopharynx.Conclusion Nitroglycerine shortens the time of rewarming rectum during cardiopulmonary bypass with deep hypothermic circulatory arrest.